foundation-signup-cohort-1 - Cyborg Interactive

PARTICIPANT INFORMATION

Participant Name(Required)

First Last

Date of Birth (Age 14-18)(Required)

Grade (9-12)(Required)

PARENT/GUARDIAN INFORMATION

Parent/Guardian Name(Required)

First Last

Parent/Guardian Email(Required)

Enter Email Confirm Email

Primary Phone(Required)

Primary Phone Type(Required)

Cell

Home

Work

Secondary Phone

Secondary Phone Type

Cell

Home

Work

IMPORTANT: Additional forms will be sent this address.

THE DEADLINE FOR RETURNING THESE FORMS IS 7 DAYS PRIOR TO THE START OF THE PROGRAM

These must be filled out and returned to Cyborg Interactive in order for your child to participate in the program.

This includes forms for:
Parental Consent
Liability Acknowledgement
Medical Information
Photo/Video Permission.

Please mail these to:
ATTN: Adrian Maggio
Cyborg Interactive
326 Broad St.
Suite 112
Utica NY, 13501

Address(Required)

Street Address Address Line 2 City State ZIP Code

BACKGROUND INFORMATION

How did you hear about this program?(Required)

How you heard about this (other)

Does your teen have any prior programming experience?(Required)

Yes

Programming experience:

What are your teen's main game development interests?(Required)

Programming

Game Design

Art

Music/Audio

Writing/Narrative Design

Other

Other game development interests:

What does your teen hope to get out of this bootcamp?(Required)

Does your teen have any learning accommodations we should be aware of?(Required)

Yes

Learning Accommodations

Signature(Required)

PAYMENT DETAILS

Discount for being a part of the inaugural cohort:(Required)

Price:

Cyborg Interactive’s 3-Day Game Dev Foundations Bootcamp – 2025 Cohort #1(Required)

Pay Deposit $150.00

Pay In Full $395.00

Cyborg Interactive’s 3-Day Game Dev Foundations Bootcamp – an immersive weekend experience designed to help high school students harness their passion for games and turn it into valuable skills for the future.

IMPORTANT: Any remainder will be billed to you, and is due 7 days prior to the start of the bootcamp.

Total

Payment(Required)

– GAME DEVELOPMENT FOUNDATIONS – SESSION 1 – SIGN UP –

PARTICIPANT INFORMATION

PARENT/GUARDIAN INFORMATION

BACKGROUND INFORMATION

PAYMENT DETAILS